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Poor dietary habits and low physical activity levels among children are risk factors for subsequent morbidity in adolescence and morbidity and mortality in adulthood for conditions including cardiovascular disease, obesity, and diabetes. Nutrition and physical activity among children in the United States warrants improvement. Over 80% of U.S. children consume more than the recommended amount of total fat and approximately 1% of children aged 2 to 19 years meet the federal recommendations for a healthy diet. Children are also becoming increasingly sedentary; one identifiable cause of this increased inactivity is excess television viewing. School-based programs that improve physical activity and dietary habits are especially beneficial because of the near universal enrollment of children and the school's potential to affect behaviors at a young age.

The Program

Eat Well and Keep Moving is an interdisciplinary school-based program designed to improve diet and physical activity levels among 4th and 5th graders. The program is integrated into existing school curricula via an interdisciplinary approach using classroom teachers. For each grade, there are 13 classroom lessons (total of 26 over 2 years) in math, science, language arts, and social studies. Links to school food service and physical education activities are also provided. The intervention focuses on decreasing total fat intake, increasing fruit and vegetable intake, reducing television viewing, and increasing physical activity.

The intervention is delivered over 2 years, 13 classroom lessons per year. Each lesson is designed for a 50-minute class period. Five physical education lessons are designed for a 30-minute class period. Time required to implement the three individual campaigns to limit television, increase exercise, and increase fruit and vegetable consumption varies depending on family and school staff response. Classroom teachers attended a one day training and two staff wellness meetings each year.

Intended Audience

Participants were 4th and 5th graders when the study began in Baltimore, MD; 59% female; 91% Black.

Suitable Settings

The intervention is intended for school settings.

Required Resources

The "Eat Well & Keep Moving: An Interdisciplinary Curriculum for Teaching Upper Elementary School Nutrition and Physical Activity" manual is required. The manual is available for $45.00.

About the Study

Six intervention schools were matched with 8 control schools in Baltimore, MD. Fourth and fifth grade students in the intervention group received 13 classroom lessons each year of Eat Well and Keep Moving. Classroom teachers delivered the intervention during math, science, language arts, and social studies classes. In grade 5, students received five physical education lessons focused on nutrition issues, using a "Safe Workout" format. The intervention also included three campaigns: "Get 3-at-School & 5-a-Day," to promote fruit and vegetable consumption; "MTV Unplugged," to limit television viewing time; and "Walking Clubs," to increase walking. These classroom-based campaigns included activities to complete at home and increased opportunities for students to use acquired skills and build links with families and the community.

Results indicated:

Based on 24-hour recall and cross-sectional data, intervention students as compared to control students, reduced their percentage of calories from fat.

Based on 24-hour recall, intervention students increased their consumption of fruit and vegetable, vitamin C, and fiber compared to control students.